Study On The Therapeutic Effect And Mechanism Of Guizhi Decoction On Chronic Urticaria Based On Meta-analysis And Network Pharmacology

Study one:Meta-analysis of clinical efficacy of Guizhi Decoction in the treatment of Chronic UrticariaObjective: To systematically evaluate the clinical efficacy of Guizhi Decoction in the treatment of chronic urticaria.Method:Computers apply retrieval strategies,All published clinical randomized controlled trials（RCTS）of Guizhi Decoction in the treatment of chronic urticaria were searched on CNKI,WA NFANG、CBM、Pub Med、Embase and VIP.The retrieval time was from the establishment of the database to November 20,2021.After the establishment of a unified screening standard,two researchers independently conducted literature screening,extracted relevant data,summarized the results,and formulated the screening flow chart.The Cochrane Bias assessment tool was used to assess the risk of the included literature.STATA 15.0 was used for Metaanalysis.Results : Ten literatures were included in this study,with a total of 795 cases,including 398 cases in experimental group and 397 cases in control group.Meta-analysis results showed that:The total effective rate [RR=1.19,95%CI（1.13,1.25）,Z=6.32,p<0.001] and cure rate [RR=1.65,95%CI（1.38,1.98）,Z=5.38,P< 0.001] of the experimental group combined with Guizhi Decoction on the basis of conventional western medicine treatment were higher than those of thecontrol group.In improving the itch integral[SMD=1.88,95%CI（2.12,1.63）,Z=14.08,p<0.05]、the integral of the number of wheal[SMD=2.41,95%CI（2.67,2.15）,Z=18.19,P < 0.05] and the integral of the size of the wheal [SMD = 2.75,95%CI（3.15,2.35）,Z=13.57,p < 0.05] were better than the control group.The adverse reaction rate was lower than that of the control group [RR=0.27,95%CI（0.11,0.66）,Z=2.87,P < 0.05].In terms of safety,there were no serious adverse reactions occurred,only mild symptoms such as dry mouth,drowsiness,dizziness and nausea,which could disappear after drug withdrawal.Conclusion: The effect of Guizhi Decoction in the treatment of Chronic Urticaria is superior to conventional western medicine group,but the study about this literature is less,the adverse reaction rate or other description of influencing the security is too little,still need to carry out multicenter,high quality,large sample randomized controlled clinical trials,providing reliable reference data for Guizhi Decoction for treatment of chronic urticaria.Study two: Study on the mechanism of Guizhi Decoction in the treatment of Chronic Urticaria based on Network Pharmacology Objective:To explore the mechanism of Guizhi Decoction in the treatment of chronic urticaria（CU）by network pharmacology method.Methods: The active ingredients of Guizhi Decoctiona and corresponding human target proteins were extracted based on TCMSP,and the gene names were obtained by matching human target proteins with Uni Prot database and Pharm Mapper database,and the drug-ingredients-target network map was constructed.The disease targets of CU were obtained from Gene Cards database and OMIM database,and the intersection targets of Guizhi Decoction for CU were obtained by Using jvenn platform.The intersection targets were imported into STRING database for the analysis of protein interaction,and then constructing PPI network diagram.Metascape platform was used for GO enrichment analysis and KEGG pathway enrichment analysis of the intersection targets.Cytoscope3.7.1software was used to construct the ingredients-target-pathway network diagram.Results: A total of 146 active components were screened from Guizhi Decoction,384 potential targets were predicted,and 994 targets of CU were obtained.There are 113 common targets of diseases and herbs,and the core targets include CAT、STAT3、EGF、TP53、ERBB2、EGFR、CASP3,etc.GO functional enrichment analysis show that a total of 1904 items were obtained,including 1684 items of biological processes（BP）,such as inflammatory response、response to inorganic substance、cellular response to nitrogen compound、positive regulation of protein phosphorylation,etc.76 entries in cell composition（CC）,including side of membrane、 vesicle lumen、perinuclear region of cytoplasm,and extracellular matrix,and 144 entries in molecular function（MF）,including serine hydrolase activity 、 cytokine receptor binding 、 kinase binding,and G-protein-coupled acetylcholine receptor activity.A total of 186 items were obtained from KEGG pathway enrichment analysis,including NF-kappa B signaling pathway、Apelin signaling pathway、thyroid hormone signaling pathway、 Th17 cell differentiation、calcium signaling pathway,etc.The ingredients-targets-pathway network diagram showed that quercetin、kaempferol、naringin、beta-sitosterol and（+）-catechin may be the main components of Guizhi Decoction in treating CU,while PTGS2、 ACHE、 PPARG、 CRP and MMP9 may be the main gene targets of Guizhi Decoction in treating CU.Conclusion: From the perspective of network pharmacology,this paper revealed that Guizhi Decoction treated CU through the coordination of multiple pathways,multiple targets and multiple pathways,providing reference basis and entry point for further research on the physical basis and molecular mechanism of pharmacodynamics.